Free MDOS, Repair Facility Change of Address Notification Form - Michigan

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Repair Facility Change of Address Notification
Dear Repair Facility Owner: Please use this form to notify Licensing Unit of a change in your business address. The business address cannot be updated until notification of this change is received in writing. Please complete the following: Facility License Number: ______________________________ Business Name: ______________________________________ Street Address: _______________________________________ City/State/Zip: ________________________________________ Owner's Signature: ____________________________________ Owner's Printed Name: _________________________________ Return this notification to: Michigan Department of State Bureau of Regulatory Services Licensing Unit Lansing, MI 48918 Or fax the completed form to (517) 335-2810. If you have any questions, please contact Licensing Unit at 1-888-SOS-MICH (1-888-767-6424). Sincerely,

Licensing Unit Bureau of Regulatory Services

BUREAU OF REGULATORY SERVICES, LICENSING UNIT RICHARD H. AUSTIN BUILDING h 3RD FLOOR h 430 W. ALLEGAN h LANSING, MICHIGAN 48918 www.Michigan.gov/sos h 1-888-SOS-MICH (1-888-767-6424)